Skip to content
  • About
  • Contact
  • Contribute
  • What Physicians Say
  • My Book
  • Careers
  • Podcast
  • Speaking
KevinMD.com — Social media's leading physician voice
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
    • All
    • Physician
    • Burnout
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • About
    • Contact
    • Contribute
    • What Physicians Say
    • My Book
    • Careers
    • Podcast
    • Speaking
KevinMD.com — Social media's leading physician voice
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
    • All
    • Physician
    • Burnout
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • About
    • Contact
    • Contribute
    • What Physicians Say
    • My Book
    • Careers
    • Podcast
    • Speaking
  • About Kevin Pho, MD, Founder of KevinMD
  • Aging and dementia: what physicians say, in their own words
  • Artificial intelligence: what physicians say, in their own words
  • Be heard on social media’s leading physician voice
  • Cancer: what physicians say, in their own words
  • Children’s health: what pediatricians say, in their own words
  • Contact Kevin
  • COVID-19: what physicians wrote as it happened
  • Custom enhanced author page pricing
  • Diabetes and obesity: what physicians say, in their own words
  • Direct primary care: what physicians say, in their own words
  • DMCA Policy
  • End of life: what physicians say, in their own words
  • Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices
  • GLP-1 drugs: what physicians say about Ozempic and its successors, in their own words
  • Heart disease: what physicians say, in their own words
  • Immigration and medicine: what physicians say about immigrant doctors and immigrant patients, in their own words
  • KevinMD influencer opportunities
  • Medical errors: what physicians say, in their own words
  • Medical ethics: what physicians say, in their own words
  • Medical malpractice: what physicians say, in their own words
  • Medical school: what students and physicians say, in their own words
  • Mental health: what psychiatrists and physicians say, in their own words
  • Nursing: what nurses and physicians say, in their own words
  • Opinion and commentary by KevinMD
  • Opioids: what physicians and pain patients say, in their own words
  • Physician burnout speakers to keynote your conference
  • Physician burnout: what physicians say, in their own words
  • Physician Coaching by KevinMD
  • Physician keynote speaker: Kevin Pho, MD
  • Physician personal finance: what physicians say about their own money, in their own words
  • Physician Speaking by KevinMD: a boutique speakers bureau
  • Physician suicide: what physicians say, in their own words
  • Physicians and administrators: what physicians say about who runs medicine, in their own words
  • Primary care physician in Nashua, NH | Kevin Pho, MD
  • Primary care: what physicians say, in their own words
  • Prior authorization: what physicians say, in their own words
  • Privacy Policy
  • Private equity and corporate medicine: what physicians say, in their own words
  • Race and medicine: what physicians say, in their own words
  • Recommended services by KevinMD
  • Residency: what residents and attendings say, in their own words
  • Scope of practice: what physicians, nurse practitioners, and PAs say, in their own words
  • Subscribe to the KevinMD enhanced author page
  • Subscribe to the newsletter
  • Surgeons and surgery: what surgeons say, in their own words
  • Take-home messages: what physicians say when asked to leave one
  • Terms of Use Agreement
  • Thank you for subscribing to KevinMD
  • Thank you for upgrading to the KevinMD enhanced author page
  • The electronic health record: what physicians say, in their own words
  • Vaccines: what physicians say, in their own words
  • Violence against health care workers: what physicians and nurses say, in their own words
  • What physicians say: the KevinMD records
  • Women in medicine: what women physicians say, in their own words
  • Women’s health: what physicians say, in their own words

Duty-hour regulations do not define me as a doctor

Rohit Devnani, MD
Medical Education
June 2, 2014
Share
Tweet
Share

I argue with my father a lot. He works as an intensivist at a community hospital in Indianapolis while I am about to graduate from a highly academic internal medicine program in Chicago. Needless to say, we have very different perspectives.

He sometimes expresses views similar to those written in an article, “When I Was a Resident: How Duty Hour Rules Are Creating a Lost Generation of Physicians.” I started residency the first year that the new intern duty-hour regulations were put into effect. After explaining these rules to my father, he asked me: “How do you guys learn? When I was a resident, we did not have limits to how many patients we saw. I would be working until five or six in the evening on my post-call day and then stay to work a moonlighting shift.” I, then, delightfully asked him if that was before or after penicillin was discovered.

The field of medicine has undergone many changes (yet we still carry pagers, but that’s for another rant), some for better and some for worse. There has been much debate over potential benefits and detriments that come with the changes in duty-hour regulations.  I can only speak to the culture at my own institution, but in my experience, there is one thing that has not changed: The pride we take in our work. This is why I take particular issue with the overly dramatized notions brought up in the aforementioned article.

Now to be clear, this should not be taken as praise for the duty-hour regulations: I am not convinced that they are necessarily beneficial. Instead, this is meant to argue, on behalf of the duty-hour generation of doctors, that we are just as capable as the graduates from before these regulations were implemented. This is a look at my own “when I was a resident” short list, once I graduate at the end of June.

When I was a resident, we (also) took pride in caring for our patients. Because we were restricted by shift-work, we learned to become efficient and prioritize our tasks. Yes, many times we had to pass on duties to our colleagues who came in to relieve us at the end of our shift, but usually the most important things were taken care of. We especially took pride knowing that even once we left the hospital, our patients were being looked after by our trusted colleagues.

When I was a resident, we were taught that medicine is a team sport. We felt personally responsible for our patients and felt a personal responsibility towards each other. We frequently assured our colleagues that we would act on any critical labs, perform any critical procedures, and make any remaining assessments on their patients, because they were not just their patients; they were also our patients. We could go home because our colleagues picked us up. Our colleagues could go home because we picked them up.

When I was a resident, our program prioritized our education. With the re-structuring of the program to comply with duty-hour regulations came a re-structuring of conference schedules to allow maximum attendance. We were afforded increased opportunities for meaningful participation, as we were not burdened by excessive service requirements or post-call fatigue when we attended.

Duty-hour regulations have not made us unmotivated. Duty-hour regulations have not instilled bad habits. Duty-hour regulations have not given us poor work ethic. Most importantly, duty-hours have not made us less educated. What duty-hours have done is change our approach to how we handle our responsibilities, and with repetition, we will become good at caring for our patients in this manner.

On a personal note, I will be starting my pulmonary and critical care fellowship in July after I graduate. I am confident that, despite all these concerns regarding the duty-hour rules I trained under, that I am prepared for this role. I am confident that I have seen and cared for an adequate number of critically ill patients. I am confident that I have acquired sufficient procedural experience during my time in residency.

Maybe I am wrong. Maybe I will start fellowship and realize that I am tired. Maybe I won’t function well after answering my pager all night or maybe I will be have a hard time rounding on all the patients the morning after having to emergently come to the hospital in the middle of the night.

I suppose the next question is should I care? While some attendings have home call for a week at a time, other attendings work on a periodic night-block schedule just like I have trained under. Why should I have to work fatigued when I have a team of people to help me?

Now the truth is, I do care, as I am going into a field where making critical decisions while dealing with fatigue is a common occurrence. I feel confident in my ability to handle this as I myself focused on honing this skill during residency (or because I spent all my mandated time off partying instead of resting). That doesn’t mean, however, that it’s a necessary experience for everybody.

For another resident, with career aspirations of a primarily office based specialty such as endocrinology, I see no reason why they need to develop this skill. Similarly, I probably shouldn’t admit this before I graduate, but I am ill-experienced with knee injections. Does this make me unmotivated? Maybe, but to be fair, I probably wouldn’t have bothered learning it even before the duty-hour regulations.

ADVERTISEMENT

We all have mentors and role models that we look up to and strive to become. Here is the dirty little secret: We are not done learning once we exit residency. These mentors did not learn the skills we admire over the 3-6 years of residency, rather, they have developed via their experience over 15-25 year careers. We all have access to the same journals and resources. We all see the same pathologies when we encounter patients. We will all work with senior doctors to help guide our path as we develop over the course of our careers.

Lifelong learning is a competency championed, not only by the medical school I attended, but also by medical schools all over the country. Short of being brilliant, it’s impossible to survive medical school without having the appropriate motivation and work ethic. The graduates of medical school, in general, are passionate people with a sense of duty and responsibility. It seems unlikely to me that a single year of duty-hour regulations will ruin that foundation.

Rohit Devnani is an internal medicine resident, and can be reached on Twitter @RoRo_Nani.  This article originally appeared on CaduceusBlog.

Prev

Better outcomes and lower costs: The perioperative surgical home

June 2, 2014 Kevin 10
…
Next

Should junk foods carry warning labels?

June 3, 2014 Kevin 22
…

Tagged as: Pulmonology, Residency and Medical Training

< Previous Post
Better outcomes and lower costs: The perioperative surgical home
Next Post >
Should junk foods carry warning labels?

 

ADVERTISEMENT

More in Medical Education

  • What clinical support staff notice that charts never show

    Maria Alemu
  • Learning empathy in medical school took my father’s cancer

    Sneha Dabadi
  • Monetize clinical expertise without becoming an influencer

    Justin Allan Montgomery, MSN-FNP
  • Medical infographics now look right without being right

    Shaan R. Mody
  • Clinical uncertainty is missing from medical training

    Lohithasree Bode
  • Why nearly every pre-med now takes a gap year

    Claudia Rodriguez
  • Most Popular

  • Past Week

    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • The conflict of interest that discloses as nothing

      Martha Rosenberg | Medications
    • 4 fibromyalgia myths the current evidence doesn’t support

      Kayvan Haddadan, MD | Conditions and Diseases
    • Why exhaustion can make you see things that aren’t there [PODCAST]

      The Podcast by KevinMD | Podcast
    • AI governance in health care has to reach the exam room

      Amanda Heidemann, MD | Health Technology
    • The Pennsylvania measles outbreak and the cost of forgetting

      Christine King, CRNA | Conditions and Diseases
  • Past 6 Months

    • Why CDC opioid guidelines get the overdose data wrong

      Richard A. Lawhern, PhD | Conditions and Diseases
    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • Sensory processing in autism and the brain’s volume control

      Josette Pelatan, PhD | Conditions and Diseases
    • What maternity care deserts cost a town

      Manisha Kaliaperumal | Health Policy
    • Why medicine needs a national physician license now

      Vaishali Popat, MD, MPH | Physician
    • A cold cost $945. The cost of primary care is broken.

      Susan Newman, MD | Physician
  • Recent Posts

    • Why exhaustion can make you see things that aren’t there [PODCAST]

      The Podcast by KevinMD | Podcast
    • 3 reforms to counter wellness influencers in practice

      Farid Sabet-Sharghi, MD | Physician
    • Shift work and circadian rhythms shape the 24/7 workplace

      Deepak Gupta, MD | Conditions and Diseases
    • Paid for twice

      Physicians paid for G2211 twice. Most never bill it.

      Michael Duben, MD | Physician Finance
    • The next child

      Medicaid managed care and the case for mutual stewardship

      Steven Merahn, MD | Health Policy
    • Choosing a limb lengthening surgeon requires accountability

      Hrayr Basmajian, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 51 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • The conflict of interest that discloses as nothing

      Martha Rosenberg | Medications
    • 4 fibromyalgia myths the current evidence doesn’t support

      Kayvan Haddadan, MD | Conditions and Diseases
    • Why exhaustion can make you see things that aren’t there [PODCAST]

      The Podcast by KevinMD | Podcast
    • AI governance in health care has to reach the exam room

      Amanda Heidemann, MD | Health Technology
    • The Pennsylvania measles outbreak and the cost of forgetting

      Christine King, CRNA | Conditions and Diseases
  • Past 6 Months

    • Why CDC opioid guidelines get the overdose data wrong

      Richard A. Lawhern, PhD | Conditions and Diseases
    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • Sensory processing in autism and the brain’s volume control

      Josette Pelatan, PhD | Conditions and Diseases
    • What maternity care deserts cost a town

      Manisha Kaliaperumal | Health Policy
    • Why medicine needs a national physician license now

      Vaishali Popat, MD, MPH | Physician
    • A cold cost $945. The cost of primary care is broken.

      Susan Newman, MD | Physician
  • Recent Posts

    • Why exhaustion can make you see things that aren’t there [PODCAST]

      The Podcast by KevinMD | Podcast
    • 3 reforms to counter wellness influencers in practice

      Farid Sabet-Sharghi, MD | Physician
    • Shift work and circadian rhythms shape the 24/7 workplace

      Deepak Gupta, MD | Conditions and Diseases
    • Paid for twice

      Physicians paid for G2211 twice. Most never bill it.

      Michael Duben, MD | Physician Finance
    • The next child

      Medicaid managed care and the case for mutual stewardship

      Steven Merahn, MD | Health Policy
    • Choosing a limb lengthening surgeon requires accountability

      Hrayr Basmajian, MD | Physician

Copyright © 2026 KevinMD.com | Powered by Astra WordPress Theme

  • Terms of Use Agreement
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Duty-hour regulations do not define me as a doctor
51 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...